Addison's Disease (Primary Adrenal Insufficiency)
What is Addison's Disease (Primary Adrenal Insufficiency)?
Addison's disease is a rare condition where your adrenal glands do not make enough cortisol and aldosterone. These small glands sit on top of your kidneys and produce hormones that regulate blood pressure, metabolism, and stress response. When they stop working properly, your body struggles to maintain normal functions.
Cortisol helps your body respond to stress, maintain blood sugar levels, and reduce inflammation. Aldosterone controls sodium and potassium balance in your blood. Without enough of these hormones, you may feel extremely tired and experience dangerous drops in blood pressure.
Most cases develop slowly over months or years. About 1 in 100,000 people develop Addison's disease each year. Early detection through blood testing helps prevent life-threatening complications called adrenal crisis.
Symptoms
- Extreme fatigue and muscle weakness that worsens over time
- Unexplained weight loss and decreased appetite
- Low blood pressure that causes dizziness when standing
- Darkening of skin, especially on scars, skin folds, and gums
- Salt cravings and craving for salty foods
- Nausea, vomiting, and diarrhea
- Muscle or joint pain
- Irritability and depression
- Low blood sugar, especially in children
- Irregular or absent menstrual periods in women
Symptoms often develop gradually and may be mistaken for other conditions. Many people do not realize they have Addison's disease until a stressful event triggers an adrenal crisis. This medical emergency requires immediate treatment.
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Causes and risk factors
About 70% of Addison's disease cases result from autoimmune destruction of the adrenal glands. Your immune system mistakenly attacks and damages the outer layer of the adrenal glands. This process often occurs alongside other autoimmune conditions like thyroid disease or type 1 diabetes. Infections such as tuberculosis, HIV, and fungal diseases can also damage the adrenal glands. Less common causes include cancer spreading to the adrenal glands, surgical removal of adrenal tissue, and bleeding into the adrenal glands.
Certain genetic conditions increase your risk of developing Addison's disease. People with family members who have autoimmune disorders face higher risk. Long-term use of blood thinners may cause adrenal bleeding. Medications that block cortisol production, like ketoconazole, can also contribute to adrenal insufficiency. The condition affects all ages but most commonly appears between ages 30 and 50.
How it's diagnosed
Doctors diagnose Addison's disease through blood tests that measure hormone levels and electrolyte balance. The ACTH stimulation test is the gold standard for diagnosis. It measures how your adrenal glands respond when stimulated by adrenocorticotropic hormone. Blood tests also check cortisol levels, which are typically low in the morning when they should be highest. Sodium levels are often low while potassium levels are high. Carbon dioxide levels in your blood may be low, indicating metabolic acidosis.
Rite Aid offers blood testing that includes carbon dioxide measurement, which can reveal electrolyte imbalances associated with Addison's disease. Testing at over 2,000 Quest Diagnostics locations makes it easy to monitor your health. Your doctor may order additional specialized tests to confirm the diagnosis and determine the underlying cause.
Treatment options
- Daily hormone replacement therapy with hydrocortisone or prednisone to replace cortisol
- Fludrocortisone acetate to replace aldosterone and maintain sodium balance
- Increase medication doses during illness, injury, or stressful events
- Eat a diet rich in sodium to maintain blood pressure and electrolyte balance
- Carry an emergency injection kit with hydrocortisone for adrenal crisis
- Wear a medical alert bracelet identifying your condition
- Regular blood tests to monitor electrolyte levels and medication effectiveness
- Work closely with an endocrinologist who specializes in hormone disorders
- Stay hydrated and avoid extreme heat or prolonged exercise without proper medication adjustment
- Learn to recognize signs of adrenal crisis and seek immediate medical care
Concerned about Addison's Disease (Primary Adrenal Insufficiency)? Get tested at Rite Aid.
- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
Addison's disease is a verified medical condition where your adrenal glands fail to produce enough hormones. It can be diagnosed through blood tests and requires lifelong hormone replacement. Adrenal fatigue is not a recognized medical diagnosis and lacks scientific evidence. If you feel persistently tired, see a doctor for proper testing.
Addison's disease cannot be cured, but it can be managed effectively with daily hormone replacement therapy. Most people with properly managed Addison's disease live normal, active lives. Treatment requires lifelong medication and regular monitoring. Missing doses can lead to serious complications.
An adrenal crisis is a life-threatening emergency that occurs when cortisol levels drop too low. Symptoms include severe vomiting, diarrhea, dehydration, low blood pressure, confusion, and loss of consciousness. Without immediate treatment with intravenous steroids and fluids, it can be fatal. Anyone with Addison's disease should carry emergency medication and know when to seek help.
Most doctors recommend blood tests every 3 to 6 months to monitor electrolyte levels and medication effectiveness. Your carbon dioxide, sodium, and potassium levels help guide medication adjustments. More frequent testing may be needed when changing medication doses or if you have symptoms. Regular monitoring prevents complications and ensures proper treatment.
Yes, you can exercise with Addison's disease, but you may need to adjust your medication on active days. Physical stress increases your body's need for cortisol. Many people take extra hydrocortisone before intense workouts or competitions. Stay well hydrated and listen to your body. Talk to your doctor about creating an exercise plan that works for you.
Salt cravings occur because low aldosterone causes your kidneys to lose too much sodium. Your body senses this sodium deficiency and triggers cravings to replace it. Many people with undiagnosed Addison's disease notice intense desires for salty snacks, pickles, or adding extra salt to food. This symptom often improves once treatment begins.
Yes, Addison's disease requires lifelong daily medication to replace the hormones your adrenal glands no longer produce. Your body cannot survive without cortisol and aldosterone. Missing even a few doses can trigger an adrenal crisis. Think of it like insulin for type 1 diabetes. The medication replaces what your body should naturally make.
Stress increases your body's demand for cortisol, which your adrenal glands cannot provide. Physical stress from illness, surgery, or injury requires medication dose increases. Emotional stress can also affect your symptoms. Your doctor will teach you when and how to adjust your medication during stressful periods.
Skin darkening occurs because low cortisol triggers your pituitary gland to make more ACTH. This hormone stimulates melanin production, the pigment that colors your skin. Darkening appears first on sun-exposed areas, scars, skin creases, and mucous membranes. Not everyone develops this symptom, but when present, it can be an important diagnostic clue.
Yes, women with well-managed Addison's disease can have healthy pregnancies and babies. Medication doses typically need adjustment during pregnancy and delivery. Close monitoring by both an endocrinologist and obstetrician is essential. Stress of labor and delivery requires increased cortisol doses. With proper care, most pregnancies proceed without major complications.